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R518
R518 – Mandibular osteotomies for prognathism - sagittal split
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R518 is a surgical procedure for a mandibular osteotomy for prognathism, specifically using the sagittal split technique. This procedure falls under orthognathic surgery. The fee for the surgeon (suffix A) is a set amount, while the fees for the assistant (suffix B) and anaesthetist (suffix C) are calculated based on basic units and time units.
When to Use
- Use R518 specifically for sagittal split osteotomy procedures performed to correct mandibular prognathism.
- Use this code for the primary surgical fee (suffix A) when the procedure is performed in a hospital setting.
Common Pitfalls
- Billing a hospital admission assessment as a separate claim; only the 'major pre-operative visit' (the consultation where the decision to operate is finalized) is eligible for payment alongside this code.
- Attempting to bill for a second surgical assistant without prior authorization, as R518 is not on the list of procedures permitting a second assistant without a formal letter of justification.
Billing Tips
- Ensure that if the patient is under 16, the appropriate age-based premium is applied to both the surgeon (suffix A) and the surgical assistant (suffix B) claims.
- When billing for anaesthesia or surgical assistance, remember that after-hours premiums (E400 series) are calculated based on the start time of the procedure, not the duration.
Provider Fee$932.10
Surgical Assistant Fee$75.06
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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